New effective but expensive cancer treatments and tax changes for revenue raising for medical treatment

[Speaking in the Seanad during Order of Business]

I will give some good and some bad news and in the process ask the Deputy Leader and the representatives of the Government parties to communicate to the Minister for Health and possibly to schedule a debate in this Chamber on an issue that has become a low-level national emergency.

I will give the bad news first on this beautiful sunny summer’s day. The incidence of malignant melanoma in Ireland has skyrocketed in recent years. This is a cancer which in its earliest stages should be cured if it is removed with a simple excision of the affected area of the skin, but in many cases it is not cured. It is a disease that can present with a more advanced disease or which has propensity for relapse. The scary thing is that historically, this disease when it comes back has been very difficult to treat and is usually fatal.

The incidence of the disease has skyrocketed in Ireland in recent years. This is totally due to increased sun exposure. As a national group we are not well endowed with defences against the sun. We were designed for spending our time in the grey misty skies of north-western Europe. Now that we have more opportunities to access the sun through travel we are seeing a colossal increase. This is not just some visitation from God. This is something we do to ourselves and we can do something about it.

I will now give the good news. Last week in Chicago, at the conference of the American Society of Clinical Oncology, extraordinary data were presented about newer immune system treatments for the minority of patients who have advanced secondary malignant melanoma. Without boring Members with all the details, this was a large 1,000-patient study. I am very proud to say approximately 20 members, who were recruited through the All-Ireland Co-operative Oncology Research Group, an organisation which I, along with my colleague John Armstrong founded 17 years ago, were part of this trial and contributed to the data. More than 50% of patients with this advanced, usually incurable cancer had major remissions of their cancer. Approximately 20% to 25% of them had a complete disappearance of the cancer. We believe it is likely that many of those patients will be cured. So this is a stunning event.

The problem is that it will be extraordinarily costly. The other information that came from Chicago last week is that these types of new immune system treatments, which were of use principally in relatively uncommon cancers, may work in lung cancer, some types of bowel cancer, possibly in bladder cancer and in a variety of other diseases. So a torrent of data may become available to us over the next year or two that these new and very expensive drugs have life-saving potential.

We need to do some forward planning. There is no doubt that we will be spending a bit more on drugs if we approve these drugs. I make a specific suggestion to the Government party leadership because we cannot initiate money Bills here or make specific financial proposals. I would like if somebody in the Government would take on board as a project a plan for the next budget to impose an additional €5 tax on a pack of cigarettes which would be ring-fenced for one purpose only, which would be the provision of expensive drugs and medications for people who get smoking-related diseases. I would not be so sectarian as to deny my colleagues in cardiology access to this as well. The money should be designated for the treatment of diseases caused by smoking.

This would have the twin effects of raising revenue and disincentivising people from smoking. I believe this should be done. We have talked about it in the past. This country is not good at ring-fencing taxes and the reality is that tax gets a bad rap. We know what has happened in the past with tax money being frittered away in the financial sector and on things that were completely non-productive.

We should take this on board as a policy and ring-fence the €5 additional tax. We should also put a tax on sunbeds to be used to address the same issue. We should then completely remove all VAT from sun-protection products, which should be considered as medicinal agents. Otherwise not only will we have the tragedy of many people – many of them young – getting incurable cancer, but we will also have the financial consequences of paying for the treatments we will not be able to afford, some of which will costs hundreds of thousands of euro.

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